Impact of Adjuvant Medical Therapies on Surgical Outcomes in Idiopathic Subglottic Stenosis.
Impact of Adjuvant Medical Therapies on Surgical Outcomes in Idiopathic Subglottic Stenosis.
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DOI：
10.1002/lary.29675
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发表时间：
2021-12
期刊：
影响因子：
--
通讯作者：
North American Airway Collaborative
中科院分区：
文献类型：
--
作者：
Hoffman MR;Patro A;Huang LC;Chen SC;Berry LD;Gelbard A;Francis DO;North American Airway Collaborative
辅助药物包括质子泵抑制剂(PPI)、抗生素(甲氧苄氨嘧啶/磺胺甲恶唑，TMP-SMX)和吸入性皮质类固醇(ICS)，可与特发性声门下狭窄(ISGS)的手术结合使用。我们描述了内窥镜扩张(ED)或内窥镜切除加内科治疗(ERMT)的辅助用药模式，并评估了对治疗结果的影响。询问北美航空公司的合作数据，以确定患者是否接受了辅助药物治疗(S)。主要结果是再手术时间，采用Kaplan-Meier曲线和Cox回归分析进行评估。比较12个月后呼气峰流速(PEF)和临床慢性阻塞性肺疾病问卷(CCQ)评分变化的二次结局。61/129例ED患者接受PPI治疗(47%)，10/143例接受ICS治疗(7%)。TMP-SMX用于EMRT的患者为87/115例(76%)。ED组使用PPI对复发时间(HR=1.00，95%CI：0.53~1.88；p=0.99)或12个月的PEF变化(L/分钟)(中位数(智商)，12.0(10.7~12.2)vs 8.7(−5.1~24.9)；p=0.59)没有影响，但与12个月的CCQ评分变化(−0.05(−0.97~0.75)vs−0.50(−1.60~0.20))有关；P=0.04)。ICS不影响结果衡量标准。TMP-SMX在ERMT中的应用不影响复发时间(HR=0.842，95%CI：0.2345，3.023；p=0.79)，12个月的PEF75(68-89)vs.81(68-89；p=0.92)，或12个月CCQ评分的变化(0.2(−1.05-0.47)vs.−0.30(−1.00-0.10)；p=0.45)。没有开出辅助药物的标准做法。这些数据不支持使用辅助药物会延长复发时间或增加PEF。患有ISGS和GERD的患者使用PPI可能会体验到一些症状缓解。
Adjuvant medications including proton pump inhibitors (PPI), antibiotics (trimethoprim/sulfamethoxazole, TMP-SMX), and inhaled corticosteroids (ICS) may be prescribed in conjunction with surgery for idiopathic subglottic stenosis (iSGS). We describe adjuvant medication use patterns with endoscopic dilation (ED) or endoscopic resection with medical treatment (ERMT) and evaluate impact on treatment outcomes. North American Airway Collaborative data were interrogated to determine if patients received adjuvant medications(s). Primary outcome was time to recurrent operation, evaluated using Kaplan-Meier curves and Cox regression analysis. Secondary outcomes of change in peak expiratory flow (PEF) and clinical chronic obstructive pulmonary disease questionnaire (CCQ) score over 12 months were compared. 61/129 patients undergoing ED received PPI (47%), and 10/143 patients undergoing ED received ICS (7%). TMP-SMX was used by 87/115 patients (76%) undergoing EMRT. PPI use in the ED group did not affect time to recurrence (HR=1.00, 95% CI: 0.53–1.88; p=0.99) or 12-month change in PEF (L/min) (median (IQR), 12.0 (10.7–12.2) vs. 8.7 (−5.1–24.9); p=0.59), but was associated with 12-month change in CCQ score (−0.05 (−0.97–0.75) vs. −0.50 (−1.60–0.20); p=0.04). ICS did not affect outcome measures. TMP-SMX use in ERMT did not affect time to recurrence (HR=0.842, 95% CI: 0.2345, 3.023; p=0.79), PEF at 12 months (75 (68–89) vs. 81 (68–89); p=0.92), or 12-month change in CCQ score (0.20 (−1.05–0.47) vs. −0.30 (−1.00–0.10); p=0.45). There is no standard practice for prescribing adjuvant medications. These data do not support that adjuvant medication use prolongs time to recurrence or increases PEF. Patients with iSGS and GERD may experience some symptom benefit with PPI use.
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DOI：
10.1002/lary.25708
发表时间：
2016-06
期刊：
The Laryngoscope
影响因子：
--
作者：
Gelbard A;Donovan DT;Ongkasuwan J;Nouraei SA;Sandhu G;Benninger MS;Bryson PC;Lorenz RR;Tierney WS;Hillel AT;Gadkaree SK;Lott DG;Edell ES;Ekbom DC;Kasperbauer JL;Maldonado F;Schindler JS;Smith ME;Daniero JJ;Garrett CG;Netterville JL;Rickman OB;Sinard RJ;Wootten CT;Francis DO
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Francis DO
DOI：
10.1177/0194599820959674
发表时间：
2021-04
期刊：
Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery
影响因子：
--
作者：
Frank-Ito DO;Cohen SM
通讯作者：
Cohen SM
影响因子：
7.8
作者：
Carpenter, Delaney J.;Ferrante, Sergio;Daniero, James J.
通讯作者：
Daniero, James J.
影响因子：
7.8
作者：
Gelbard, Alexander;Anderson, Catherine;Francis, David O.
通讯作者：
Francis, David O.
影响因子：
2.6
作者：
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Johnston, Nikki